Antrag auf Einbürgerung gem. Art. 116 Abs. 2GG · for naturalization pursuant to Article 116 (2) of the Basic Law (GG) for the Federal Republic of Germany - for persons under 16

Bundesverwaltungsamt, as at January 2019

AK Application

for naturalization pursuant to Article 116 (2) of the Basic Law

(GG) for the Federal Republic of Germany

- for persons under 16 years -

1 Data concerning the child (applicant) (Provide more detailed or additional information, if necessary, on a separate sheet.)

1.1 Family name:

1.2 Name at birth: - if different from the family name -

1.3 Given name(s): - Enter all given names, please. -

1.4 Date of birth: Sex:

female

male 1.5

Place or administrative district:

1.6 Country of birth:

1.7 Descent: the child is a natural child

of his/her parents

this child was adopted ... Please, append relevant certificates / documentary evidence.

by both parents

by the father

by the mother

1.8

The child’s current citizenship(s): Please, enter all citizenships of the child.

Citizenship Date of acquisition Basis for acquisition (e.g. descent, naturalization)

1.9 Current address: - incl. postal code if applicable -

1.10 Country of residence:

2 1. Holder of rights of custody (e.g. mother) 2. Holder of rights of custody (e.g. father)

2.1 Family name: - name at birth, if different from family name -

2.2 Forename(s): - Enter all forenames, please. -

2.3 Current address: - if different from the applicant’s address -

2.4 Telephone number: - including the international dialling code -

2.5 E-mail:

2.6 The right of custody results from:

Bundesverwaltungsamt, as at January 2019

3 Other members of the child’s family have already been naturalized Please, append a copy of the certificate(s), if possible.

yes no

A naturalization process has already been carried out for the following family members:

3.1

Name (in the certificate of naturalization) Name of administration having issued the certificate

Certificate dated: Reference number specified in the certificate of naturalization

4 The child’s residence periods since birth outside his/her current home country - no residence of less than 6 months - (Provide more detailed or additional information, if necessary, on a separate sheet.)

4.1

from to City, town, or village Country

5 The child resided in Germany himself/herself: yes no

5.1

Period: from to Date of registration of emigration / date of emigration

last place of residence in Germany:

Please, provide the complete address (street, house number, post code, city/town/village):

6 The child’s identity document, if any

6.1

Valid identity document

passport identity document / ID card Please, append a certified

copy of the document. other:

type of document or personal ID number

Bundesverwaltungsamt, as at January 2019

7 Information on the child’s parents

Father Mother

7.1 Family name:

7.2 Name at birth and/or former names:

7.3 Given name(s): - Enter all given names, please. -

7.4 Date of birth:

7.5 Place of birth, adminis-trative district, country:

7.6. Religious affiliation: Jewish other/none Jewish other/none

7.7 Descent: is a natural child is an adopted child is a natural child is an adopted child

7.8 Citizenship (current/last citizenship):

Date of acquisition Date of acquisition

Israeli Israeli

German German

other:

other:

7.9 (former) citizenship:

from – to from – to

German German

other:

other:

7.10 Marriage: the parents’ marriage to each other

The parents were married. Place of marriage from ... (date of marriage) to … (date)

no yes

7.11 previous/later marriages

from … to … from … to …

7.12 last place of residence in Germany:

never resided in Germany never resided in Germany

yes

Name of the city/town/village

yes

Name of the city/town/village

left Germany on: left Germany on:

7.13 deceased: no no

yes deceased on (date)

yes deceased on (date)

The parents’ places of residence since birth - no residence of less than 6 months - (Provide more detailed or additional information, if necessary, on a separate sheet.)

Father Mother

7.14

from to in (town/country) from to in (town/country)

Bundesverwaltungsamt, as at January 2019

8 The child’s naturalization claim pursuant to Article 116 (2) of the Basic Law (GG) is derived from the grandparents or from a previous generation.

8.1 yes Please, fill in Annex VA for each further generation and submit it with the application or

The information on the child’s ancestors are al-ready provided in the following application:

Family name Given name

8.2

Date of birth Reference number of the file processed or kept at or of the certificate of naturalization issued by the Federal Office of Administration

8.3 no

9 Power of attorney

9.1 A power of attorney has been given. I/we wish that any correspondence is made via the person holding the power of

attorney. Please fill in ANNEX ‘VOLLMACHT’.

9.2 No power of attorney has been given. Please, make any correspondence via ...

the 1st holder of rights of custody

or the 2nd holder of rights of custody

10 Statements

I/we apply for the naturalization of the above-mentioned minor child as a German national and assure that the information I/we have provided is complete and correct.

I/we have taken notice that

the naturalization may be revoked if any false statements have been made.

I/we must inform immediately of any changes in the personal circumstances (name, address, marital status, etc.) as well as of any other information on the child provided in the application.

For information on your rights within the context of processing personal data pursuant to Articles 13 and 14 of the EU General Data Protection Regulation (GDPR), please visit the website of the Federal Office of Administration (BVA) > Staatsangehörigkeitsverfahren in Bundeszuständigkeit (in general) and the pages providing further information on the respective procedure. The Data Protection Officer’s contact details are also provided there.

10.1

Declaration with respect to the consultation of further documents

The application of the above-mentioned minor child will be processed by the Federal Office of Administration. I/we agree that the Federal Office of Administration consults further documents for processing this application provided that this is necessary. These documents may include, for instance, files on restitution or on compensation, kept at the compe-tent authorities.

I/we agree I/we do not agree

10.2

Signature on behalf of the child 1st holder of rights of custody

Signature on behalf of the child 2nd holder of rights of custody

Place and date: Place and date:

Annexes:

Annex ‘Vollmacht’

further annexes:

Annex VA Number:

Bundesverwaltungsamt, as at January 2019

Hinweise der Auslandsvertretung

Alle in Kopie beigefügten Unterlagen haben der Auslandsvertretung vorgelegen

im Original in beglaubigter Kopie als einfache Kopie

Die Echtheit der Personenstandsurkunden wird belegt/bestätigt

durch Haager Apostille. durch Legalisation.

da von Echtheitsbestätigung befreit (CIEC-Abkommen Nr. 16 v. 08.09.1976 oder bilaterale Abkommen).

Die Echtheit der Personenstandsurkunden kann nicht belegt/bestätigt werden, da

die Haager Apostille fehlt.

die Legalisationsvoraussetzungen im Land grundsätzlich nicht vorliegen.

Zweifel an der Echtheit/inhaltlichen Richtigkeit bestehen (ggf. ergänzen).

Anmerkungen:

Ort, Datum, Unterschrift und Stempel/Siegel